System and method to estimate region of tissue activation

ABSTRACT

A computer-implemented method for determining the volume of activation of neural tissue. In one embodiment, the method uses one or more parametric equations that define a volume of activation, wherein the parameters for the one or more parametric equations are given as a function of an input vector that includes stimulation parameters. After receiving input data that includes values for the stimulation parameters and defining the input vector using the input data, the input vector is applied to the function to obtain the parameters for the one or more parametric equations. The parametric equation is solved to obtain a calculated volume of activation.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.13/839,906, filed Mar. 15, 2013, which is a continuation of U.S. patentapplication Ser. No. 12/869,159, filed Aug. 26, 2010, which issued asU.S. Pat. No. 8,589,316, which claims the benefit of U.S. Prov. Pat.App. Ser. No. 61/237,375, filed Aug. 27, 2009, the entire contents ofeach of which is incorporated by reference herein. The entire contentsof each of U.S. patent application Ser. No. 13/480,858, filed May 25,2012, U.S. patent application Ser. No. 11/606,260, filed Nov. 28, 2006,U.S. Prov. Pat. App. Ser. No. 60/740,031, filed Nov. 28, 2005, U.S.Prov. Pat. App. Ser. No. 61/120,006, filed Dec. 4, 2008, and U.S. patentapplication Ser. 10/885,982, filed Jul. 7, 2004, which issued as U.S.Pat. No. 7,346,382, are also incorporated by reference herein.

GOVERNMENT FUNDING

This invention was made with government support under Grant No. NIH R01NS 059736, The U.S. government has certain rights in the invention.

TECHNICAL FIELD

The present invention relates generally to systems and methods forestimating a region of tissue activation, such as for stimulation in apatient's brain or spinal cord.

BACKGROUND

Electrical stimulation of the nervous system has provided a therapeutictreatment for a variety of disorders. For example, electricalstimulation has been applied to pain management, such as by performingstimulation of the spinal cord. Electrical stimulation has also beenperformed to augment hearing in the context of cochlear implants. Deepbrain stimulation (DES) has become an established therapy for treatingvarious conditions including, for example, Parkinson's disease anddystonia, DES has also been employed to treat several other conditions,such as clinical depression, obsessive compulsive disorder, and epilepsyto name a few.

By way of further example, the discovery that high frequency DBSgenerates clinical benefits analogous to those achieved by surgicallesioning has transformed the use of functional neurosurgery for thetreatment of movement disorders. In first world countries, thalamic DBSfor intractable tremor has replaced ablative lesions of the thalamus,and DBS of the subthalamic nucleus or globus pallidus internus (GPi).GPi has replaced pallidotomy in the treatment of the cardinal motorfeatures of Parkinson's disease (e.g., tremor, rigidity, bradykinesia).In addition, GPi DBS has emerged as an effective therapy for dystonia,and the utility of DBS is being examined for the treatment of epilepsy,obsessive-compulsive disorder, Tourette's syndrome, and majordepression.

Despite the documented clinical successes of neurostimulation, themechanisms and effects of neurostimulation at the neuronal level remaindifficult to predict. As a result, modeling and simulation have playedincreasingly important roles in the engineering design and scientificanalysis of neurostimulation.

SUMMARY

The invention relates generally to systems and methods for estimating aregion of tissue activation, such as associated with stimulation in apatient's neural tissue (e.g. brain or spinal cord).

In one embodiment, an artificial neural network (ANN) is programmed tooutput parameters of a mathematical expression that corresponds to anestimated volume of tissue activation (VTA) for a set of inputparameters (electrode configuration, stimulation parameters). A givenANN can determine the estimated VTA for different for electrodeconfigurations and stimulation parameters for which no simulations orclinical studies have been performed. Additionally, the ANN can betrained to provide the estimated VTA for a plurality of different typesof electrodes without requiring retraining of the ANN for the differenttypes of electrodes.

In another embodiment, the present invention provides acomputer-implemented method for determining the volume of activation ofneural tissue, comprising: (a) having one or more parametric equationsthat define a volume of activation, wherein the parameters for the oneor more parametric equations are given as a function of an input vectorthat includes stimulation parameters; (b) receiving input data thatincludes values for the stimulation parameters and defining the inputvector using the input data; (c) applying the input vector to thefunction and obtaining the parameters for the one or more parametricequations; and (d) solving the parametric equation to calculate thevolume of activation. The calculated volume of activation may bedisplayed on a display screen.

In another embodiment, the present invention provides a method fordetermining a function that outputs the parameters of one or moreparametric equations that define a volume of activation, comprising (a)having an electric field model of an electrode and a neural tissuemodel; (b) coupling the electric field model to the neural tissue modelto obtain volumes of activation for multiple different sets ofstimulation parameters and electrode configuration parameters; (c)fitting a geometric shape to the volumes of activation, wherein thegeometric, shape is defined by one or more parametric equations; andusing a computational training algorithm to design a function thatcorrelates the different sets of stimulation parameters and electrodeconfiguration parameters to the parameters for the one or moreparametric equations that represent the geometric shapes that are fittedto the volumes of activation. In another embodiment, the presentinvention provides a non-transitory computer-readable storage mediumcomprising instructions for determining the volume of activation usingone or more parametric equations whose parameters are given as afunction of an input vector that includes stimulation parameters andelectrode configuration parameters, wherein the function is obtained bythis method.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 depicts a functional block diagram of an example approach thatcan be employed to determine a volume of tissue activation according toan aspect of the invention.

FIG. 2 depicts an example of models that can be utilized to describe aregion of tissue activated.

FIG. 3 depicts an example of an artificial neural network that can beimplemented.

FIG. 4 depicts an example of an axon model and electrode structure thatcan be utilized to identify a region of tissue activated.

FIG. 5 depicts an example of a region of tissue activated for a firstset of stimulation parameters and configuration parameters.

FIG. 6 depicts an example of a region of tissue activated for a secondset of stimulation parameters and configuration parameters.

FIG. 7 depicts an example computer environment that can be used toperform methods and processes according to an aspect of the invention.

FIG. 8 depicts the electrode configuration for three Medtronicelectrodes used in the computational trials.

FIG. 9 depicts a Medtronic 3387 electrode in an axi-symmetric finiteelement model with the axon fibers oriented perpendicular to theelectrode shaft.

FIG. 10 depicts another example of an artificial neural network that canbe used in the present invention.

FIG. 11 depicts an example of regions of tissue activated by differentconfigurations for electrode contact activation.

DETAILED DESCRIPTION

The invention relates generally to systems and methods for estimating orpredicting a volume of neural tissue (for example, in the brain orspinal cord) activated by electrical stimulation. FIG. 1 depicts anexample of a system 10 that can be implemented to estimate a volume ofneural tissue activated, indicated as an output volume of tissueactivation (VTA) 12. The system 10 includes a VTA estimator 14 that isprogrammed to provide the output VTA for a set of input data 16. The VTAestimator 14 can employ artificial intelligence and/or machine learningtechniques (e.g., artificial neural networks, function predictors,expert systems or the like).

In the example of FIG. 1, the artificial intelligence component of theVTA estimator 14 is depicted as being artificial neural network (ANN),although it would be understood and appreciated other techniques andmethodologies could be utilized based on teachings herein. The ANN 18 istrained to provide the output VTA 12 in response to the input data 16according to the complex relationships between the input data 16described or modeled by the ANN 18.

The input data 16 includes stimulation parameters 20 and configurationparameters 22. Collectively the stimulation parameters 20 andconfiguration parameters 22 can define an input vector, based on whichthe output VTA 12 is to be calculated. It will be understood andappreciated that the particular number of dimensions for the inputvector can vary according to application requirements and capabilitiesof a corresponding ANN 18. The input stimulation parameters 20, forexample, can include an indication whether the stimulation is activatedby voltage or current control device. The input data 16 can also includestimulation parameters 20, such as voltage or current amplitude,frequency, pulse width and pulse shape.

The electrode configuration parameters 22 can define structuralcharacteristics, such as dimensions and configurations andinterrelationships for an electrode design. The configuration can be setfor commercially available electrode designs or to a custom design. Forthe example of an electrode having a plurality of cylindrical electrodecontacts, the electrode configuration parameters 22 can include theheight, diameter and spacing (or distribution) of the electrode contactsalong the electrode shaft. Relationships between parameters can also berepresented in the input data 16, such as the aspect ratio (d/h). Theaspect ratio further can be utilized to constrain the optimizationprocedure, such as by limiting the search space to a predefined range ofaspect ratios (e.g., d/h<some predefined value).

Additionally, the stimulation parameters 20 and the configurationparameters 22 can be interrelated. For instance, a given configurationof electrode can have any number of one or more electrode contacts,corresponding stimulation parameters 20 may thus be provided forstimulation of the one or more electrode contacts. Additionally, thestimulation parameters can define whether a given contact is an anode orcathode. It will be appreciated that a given set of input data (e.g.,stimulation and configuration parameters) corresponds to a given outputVTA 12. Thus there can be any number of input data 16, which can bevaried to provide corresponding output VTAs, as described herein.

The ANN 18 can employ VTA models 24 to mathematically represent ordescribe a region, which can be an area (e.g., in two dimensions) orvolume (e.g., in three dimensions) for the activated region of tissuerepresented in the output VTA 12. Thus the VTA models 24 can include aset of one or more parametric equations 26 which can be utilizedindividually or in any combination thereof in the ANN 18 for use incomputing the output VTA 12 based on the input data 16.

FIG. 2 depicts examples of some parametric equations 26 that can beutilized by the VTA estimator 14. In the example of FIG. 2, parametricequations are illustrated for an ellipsoid, a super ellipsoid as well asfor higher order polynomials. It will be understood and appreciatedother shapes and parametric equations and combinations thereof can beutilized as VTA models 24. In the example equations in FIG. 2, A and Bare the equatorial radii (along the x and y axis, respectively) and C isthe polar radius along the Z axis. The parameters r and t with respectto parametric equations control the amount of flattening at the tips atthe equator.

It will be understood and appreciated that the center of each geometricvolume described by the parametric equations 26 can represent an activeregion which may or may not be at the center of the active contacts inthe electrodes being modeled thereby. The particular center of thecontacts and the center of the active regions may differ depending on,for example, the stimulation and configuration parameters (e.g., thecontact configuration on the voltage, electrode type pulse width,impedance or other stimulation or configuration parameters) 20 and 22,respectively.

The VTA estimator 14 can utilize any number of one or more artificialneural networks (ANN) 18. By further example, the VTA estimator 14 canestimate the parameters of the mathematical parameters for theparametrical equations 26 defining the volumes of neural tissueactivated without having to perform neuronal model simulations or refitequations to a given activation spread.

As a further example, the VTA estimator 14 can employ one or moreartificial neural networks, such as two-layer neural networks depictedin FIG. 3 (see, e.g., Mathworks Neural Network Toolbox,www.mathworks.com/access/helpdesk/help/pdf_doc/nnet/nnet.pdf), to createVTA predictors programmed to estimate the parameters of the mathematicalequation(s) 26 defining the volumes of neural tissue activated.Advantageously, the estimation can be implemented without having toperform neuronal model simulations or re-fit the equations to theactivation spread. As one example case where VTAs are modeled withellipsoids, the VTA estimator 14 can be implemented with a pair oftwo-layer neural networks with sigmoid and linear transfer functions inthe hidden and output layers, respectively.

Examples of sigmoid transfer function that can be utilized in the layersof the ANN 18 are described in Narendra K. S., Parthasarathy K. (March1991) “Gradient methods for the optimization of dynamical systemscontaining neural networks,” IEEE Transactions on Neural Networks, Vol.2, No. 2, 252-262, Examples of linear transfer function that can beutilized in the layers of the ANN 18 are described Jonic S., JankovicT., Gajic V., Popovic D. (March 1999) “Three machine learning techniquesfor automatic determination of rules to control locomotion,” IEEE Trans.On Biomedical Engineering, Vol, 46, No. 3, 300-310.

Continuing with the example of two ANNs 18, one ANNs can contain 12inputs (e.g. representing pulsewidth, impedance, configuration number,voltage amplitude, contact configuration, active ellipsoids), 20 hiddenneurons, and 8 output neurons (a0, c0, a1, c1, a2, c2, a3, c3) thatdefine the ellipsoid parameters (b=a due to axi-symmetric properties ofmodel). The architecture of the second ANN 18 can be the same as thefirst, but the outputs were the centers of up to four VTAs or activeregions along the vertical axis of the electrode shaft (z0, z1, z2, z3).Those skilled in the art will understand and appreciate various types oftransfer functions (other than the sigmoidal and linear functionsdescribed above) and any numbers of layers that can be utilized toimplement the ANN 18.

The ANN 18 can be pre-trained on the system 10 such with a set oftraining data 30 so that the ANN is valid for generating the output VTA12 over a range of the input parameters 16. The system 10 can also betrained for a given application or retrained in the event that a userwishes to expand the range of the VTA estimator to accommodateadditional input data outside the range of the original training of theANN 18.

The system 10 can include a training algorithm 28 that can retrain theANN 18 based on the set of training data 30. The training data 30 can bepre-processed or normalized to provide a normalized set of training data32 according to the requirements of the ANN 18. For instance, thetraining data 30 can be obtained using computer simulations of axonalcable models.

The training algorithm 28 can implement back propagation or propagationof error based on applying the training data 30 to desired output datausing the ANN 18. As one example, each ANN 18 can be trained (orretrained) using the Levenberg-Marquardt and the gradient decent withmomentum algorithm.

Examples of possible training algorithms according to these methods aredisclosed in the following: Gill P. R., Murray W., Wright M. H. (1981)“The Levenberg-Marquardt Method” in Practical Optimization. London:Academic Press, 136-137; Levenberg K. (1944) “A Method for the Solutionof Certain Problems in Least Squares” Quart, Appl. Math, Vol. 2,164-168; and Marquardt D. (1963) “An Algorithm for Least-SquaresEstimation of Nonlinear Parameters” SIAM J. Appl. Math. Vol. 11,431-441.

As an example for initial training, some or all of the availableinput/output data corresponding to actual stimulation cases, which hasbeen utilized to determine VTAs, can be utilized to train the VTAestimator 14. A subset of the available cases can be used as validationdata to avoid over-fitting, and yet another subset or the remainingcases can be utilized to estimate the generalization error. The neuralnetwork weights and biases can be initialized randomly. Each ANN 18 canbe trained until the normalized fitting mean squared error (MSE) reacheda predetermined value (e.g., less than 1e-5), until the validation errorincreased with respect to the fitting error, or for a maximum of number(e.g., 1000) of epochs.

After the VTA estimator 14 has been programmed such as by training theANN 18, the system 10 can then be utilized to generate output VTA 12 fora set of the input data 16. To facilitate such process, the system 10can include a user interface 32 which can include a variety of buttons,drop down menus or other graphical and text based user interfaceelements, as is known in the art. The user interface 32, for example,can be utilized to provide or access a set of input data 16 or otherwisedefine a method of operation or mode of operation to be implemented bythe system 10.

The generalized relationships between the input data vector 16 andoutput VTA 12 is achieved through trained artificial neural networks. Tocalculate the parameters of the mathematical equation (s) that define aVTA, a series of simple equations can be solved. As one example, theequations can have the following form:

$I_{H} = \frac{{2I} - {\max( I_{T} )} - {\min( I_{T} )}}{{\max( I_{T} )} - {\min( I_{t} )}}$HL = IW ⋅ I_(H) + b₁ $o_{1} = \frac{1}{1 + e^{- {HL}}}$o₂ = LW ⋅ o₁ + b₂${output} = \frac{{o_{2}\lbrack {{\max( T_{T} )} - {\min( T_{T} )}} \rbrack} + {\max( T_{T} )} + {\min( T_{T} )}}{2}$

Where n is the number of hidden neurons;

m is the number of network outputs;

l is the 12×1 input vector for which we want to calculate the VTA;

max(I_(t)) and min(I_(t)) define the maximum and minimum values,respectively, that the inputs can achieve;

IW are the nx12 input weights:

b1 is the nx1 input bias vector;

o1 is a nx1 vector that contains the output from the input layer. LW andb2 are the mxn matrix of weights and mx1 vector of biases, respectively,for the hidden layer;

o2 is the mx1 normalized output vector;

max(T_(T)) and min(T_(T)) are the mx1 vectors that define the maximumand minimum values, respectively, that the outputs can achieve; and

output is the mx1 vector of parameters that define the VTA.

Referring back to FIG. 1, the system 10 can also include a modelselector 46 that is operative to select one or more VTA models 24. Themodel selector 46 can be implemented manually, such is in response touser input received via the user interface 32. Alternatively, the modelselector 46 can be implemented as an automatic process that isprogrammed to select an appropriate one or more of the parametricequations based on the input data. For instance, the model selector 46can employ a constrained optimization algorithm to minimize a costfunction formed by multiple (e.g., three) components and ensure maximumfit between the parametric equations 26 and the spread of fiberactivation corresponding to the VTA. As a further example, a first costfunction component can correspond to the difference between the mostdistal edges (on both the horizontal and vertical planes) of ourparametric equation and the 2D contour. A second component cancorrespond to the perimeter-length difference between the area coveredby the parametric equation and the 2D contours. A third component cancorrespond to the difference in area covered by the parametric equationand by the 2D active fiber contour.

In one example embodiment, a constrained optimization on the data can beperformed using the Matlab® Optimization Toolbox's fmincon function (TheMathWorks Inc., Natick, Mass.), although other commercially available orproprietary methods can be utilized. This optimization method finds aminimum of a constrained nonlinear multivariable function usingSequential Quadratic Programming (SQP) [Coleman and Zhang 2006]. SQP isdescribed in detail in the following; Powell M. J. D., (1983) “VariableMetric Methods for Constrained Optimization,” Mathematical Programming:The State of the Art, (A. Bachem, M. Grotschel and B. Korte, eds.)Springer Verlag, 288-311; Fletcher R., (1987) “Practical Methods ofOptimization,” John Wiley and Sons; Gill P. R., Murray W., Wright M. H.(1981) “The Levenberg-Marquardt Method” in Practical Optimization.London: Academic Press, 136-137; and Hock W., Schittkowski K., (1983) “AComparative Performance Evaluation of 27 Nonlinear Programming Codes,”Computing, Vol. 30, 335. Those skilled in the art will understand andappreciate other commercially available and proprietary tools andsoftware that can be utilized for selection of appropriate parametricequations 26.

Each active area thus can be described by one of the parametricequations (e.g., ellipsoids, super ellipsoids, second or higher orderpolynomials, etc.) or combination of any two or more parametricequations, such as shown in FIG. 2. While three parametric equations aredepicted in FIG. 2, those skilled in the art will appreciate that othernumbers and shapes can be utilized as parametric equations.

By way of further example, the user interface can invoke an inputselector 34 to define one or more set of input data 16, such asincluding the stimulation parameters and/or the configuration parameters20 and 22. Alternatively, the input selector 34 can be utilized toselect an input mode, such as to set the system for determining a set ofinput data that can be utilized to provide a desired target VTA. Thesystem 10 can also include a target selector 36 that is utilized todefine and set a desired target volume of tissue to be activated 38. Thetarget volume 38 can be selected via the user interface, such ascorresponding to a 2-D and/or 3-D representation, which may be presentedon a corresponding display 40. For example, the display 40 can provide athree dimensional or two dimensional representation of an anatomicalregion such as the brain in which the target volume resides. The 3-Dmodel presented on the display can correspond to a general model ofbrain anatomy. Alternatively, the model represented on the display 40can correspond to a patient-specific model, such as can be generatedusing a corresponding imaging modality (e.g., CT scan or MRI or thelike).

Where a target volume 38 has been selected via the target selector 36,the system 10 can employ a correlator 42 that is programmed to performmathematical correlation between the target volume and the output VTA12. The correlator 42 can perform correlation between the output VTA 12and the target volume 38 to calculate a volume or area of overlapbetween the output VTA and the model volume represented by the targetVTA. As one example, the correlator 42 can be programmed to perform aconstrained optimization algorithm. The corresponding results can besent to a display generator 44 and in turn reproduced for visualpresentation (and comparison) on the display 40.

Where the system 10 is being utilized to determine a set of input data16 to achieve a corresponding target volume 38 that has been selected,the input selector 34 can vary the stimulation and/or configurationparameters 20 and 22 over a range of available settings. Eachcorresponding output VTA can be correlated by the correlator 42 relativeto the target volume 38 and provided a score indicative of the amount ofoverlap. The VTAs 12 and 38 and their scores can be displayed to a user,such as by providing corresponding data to the display 40 or otheroutput device (e.g., a printer). The output VTA having a maximum amountof overlap relative to the target volume can be determined and thecorresponding input data provided as an output on the display or toanother output device (not shown).

The given set of input data thus can represent a particular structurefor an electrode as well as stimulation parameters, which can beutilized to achieve the desired target VTA. The system 10 may alsoprovide a graphical representation on the display 40 of an electrodedesign corresponding to the configuration parameters 22 for the outputVTA. The electrode design can be a commercially available design or acustom design. It will be appreciated that there can be more than onetarget VTA and thus more than set of input data for a given patient.

It will be further appreciated that for each of the different sets ofinput data (e.g., including stimulation parameters and configurationparameters) the trained ANN 18 can be, utilized for rapid evaluation ofthe respective designs to ascertain design and stimulation parameterswithout having to retrain or perform additional simulations for clinicalmeasurements. Accordingly, those skilled in the art will understand andappreciate that the system 10 and the VTA estimator 14 can be utilizedto assist the interoperative planning of electrode tracks or deep brainstimulation (DBS) or other stereotactic surgery by helping to identifyan implant location for the DBS electrodes. This could be utilized byadjusting the target volume with respect to an accordance system in theuser and determining the output VTA 12 at each respective location andfor different simulation parameters until a best match is found.

The system 10 can also include one or more other input or output devices(not shown). Such devices can provide an interface through which a usercan input data as well as control the methods. For example, a user canemploy the I/O device to input data, such as instructions to initiate ormodify the electrode design procedure. Alternatively, the I/O device canbe employed to acquire the training data 30, such as from a location inlocal memory, from another storage location, or to access anotherprocess running on another computer.

EXPERIMENTAL

The following discussion relates to activities of the inventors thatinclude experiments and procedures that provide a foundation for theconcepts described herein, including procedures used for determiningparametric equations and VTAs for training data suitable for use in anANN.

A computational model of deep brain stimulation was created to estimatethe spatial spread of neural activation within the brain andcharacterize the volumes of tissue activated. This computational of deepbrain stimulation had both anatomical and electrical components. Theelectrical components included three virtual electrodes created fromgeometric representations of Medtronic deep brain stimulation electrodes(model numbers 3389, 3387, and 3391; Medtronic, Minneapolis, Minn.), asshown in FIG. 8.

Electric Field Model

The computational modeling studies included a model of a virtualelectrode inserted inside brain tissue. The virtual electrodes weremodeled to represent Medtronic 3389, 3387, and 3391 deep brainstimulation electrodes (see FIG. 8). For each virtual electrode, over150 axi-symmetric, multi-resolution, finite element models (FEM) werecreated to model the electric field within the brain tissue. The FEMswere created using COMSOL (Comsol Inc., Burlington, Mass.) and SCIRun3.3 (Scientific Computing and Imaging Institute, Salt Lake City, Utah),and included representations of the virtual electrode, the electricalconductivity of brain tissue surrounding the electrode, capacitance atthe electrode-tissue interface, a thin layer of encapsulation tissuearound the electrode, and stimulation settings typically used inclinical applications.

The electrodes were represented as purely capacitive elements with a 3.3μf (for the Medtronic 3387 and 3389 electrodes) or 6.6 μF (for theMedtronic 3391 electrode) capacitance to reflect the contact size. Thebrain tissue was represented as a homogeneous, isotropic medium having abulk conductivity of 0.3 S/m. The model also incorporated a 0.5 mm thickencapsulation layer surrounding the electrode to account for chargetransduction reactions and a 42% voltage drop at the electrode-tissueinterface. The conductivity of the encapsulation layer in each model wasadjusted to match the target impedance. A range of stimulation settingsand electrode configurations (see Table 1 below) were applied to theelectric field model and a Fourier FEM solver was used to solvePoisson's equation with Dirichlet and Neumann boundary conditions. Theground conditions of the electric field model were the boundaries of theFEM mesh if there were no anodes present during stimulation, or theanode(s) if they were present.

TABLE 1 Electrodes: 3389, 3387, 3391 Frequency: 130 Hz Pulse-widths: 60,90, 120, 150, 180, 210, 450 μs Amplitudes: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10V Impedances: 0-749, 750-1250, 1251+ Ω Contact configurations: 15monopolar, 12 bipolar, 28 tripolar, 10 quadripolar

Neural Tissue Model

The electric field model was coupled to a neural tissue model todetermine neuronal activation. As shown in FIG. 9, the neural tissuemodel had over 2,500 trajectories of white matter axon fibers which weredistributed in a matrix perpendicular to the electrode shaft with aninter-fiber resolution of 0.2 mm along the vertical (dorsal-ventral) andhorizontal (medial-lateral) axes. The axon population was positionedabout 0.7 to 11.0 mm lateral to the electrode shaft, and −7.0 to +32.0mm above the tip of the electrode. FIG. 4 shows another illustration ofhow the axons can be arranged in a matrix adjacent the electrode shaft.A multi-compartment model of a myelinated axon was created to representeach of these axons. Axonal parameters for these models were definedaccording to McIntyre et al. for 5.7 μm axons (McIntyre et al., JNeurophysiol. 2002 February; 87(2):995-1006). The geometry required toexplicitly define the trajectory of each axon was determined usingMatlab (Mathworks Inc., Natick, Mass.). Because of the perpendicularorientation of the axons, the spread of activation relative to theelectrode shaft could be determined.

The extracellular voltages along each axon model was determined byinterpolating each electric field onto each axon compartment. The axonalbehavior in response to extracellular stimulation was simulated for allaxon models and each of the electric field FEMs using the NEURONsimulator. In this simulation, an axon was considered activated if itfired an action potential in response to the applied electric fieldsimulation.

The activated fibers were grouped into active regions. For simplicity,active regions for each active electrode contact (cathode or anode) onthe virtual electrode were defined. Each activated fiber was assigned tothe nearest active region by its distance from the center of each fiberto the center of each electrode contact. Each active region could havemore than one contact, but a given contact could only belong to a singleactive region. As such, each active region was defined as eithercathodic or anodic, depending on the nature of its correspondingelectrode contact. If an activated fiber was equidistant to a cathodeand an anode, the fiber was considered to be activated by the cathode.In some cases, adjacent active regions were merged into a single activeregion depending upon the electrode configuration and symmetry.

The two-dimensional boundaries of each active region were defined by aparametric equation for an ellipse that best encompassed the spread ofactivated fibers within its horizontal and vertical planes. Aconstrained optimization algorithm was used to find the parameters ofthis parametric equation that minimized the root mean squared (RMS)error between the actual boundaries of the active region and thegeometric outline defined by the parametric equation. The upper andlower bounds were defined by obtaining the maximum lateral and verticaldistances from each active fiber to the center of the active region.Because this was an axi-symmetric stimulation model, the 2D ellipticaloutline generated by the parametric equation could be rotated around theelectrode shaft (z-axis) to create a three-dimensional VTA. FIGS. 5 and6 depict examples of active regions 60 that can be determined bymeasuring the spread of the fibers 64 in each active region 60. Theelliptical outline 66 of each active region 60 are 2D contours on aplane parallel to the electrode contacts 62 and centered on theelectrode shaft. The edges 66 define an ellipse that has been optimallyfitted to its respective active region 60. FIG. 11 shows another exampleof active regions 60 under different configurations for electrodecontact activation. The elliptical outlines 66 of the parametricequation fitted to the active regions 60 are shown as a white linesaround active regions 60. On the electrodes 68, active contacts 62 thatare cathodes are shown as blank circles and those that are anodes areshown as cross-hatched circles.

Once the spatial spread of activation was quantified for everystimulation setting through a set of parameters describing each 2Doutline/shape artificial neural networks were used to model the complexrelationships between the electrode parameters (stimulation settings andconfigurations) and the optimally fit ellipsoid shape that representsthe volume of activation. Two feed-forward artificial neural networks(ANNs) were trained using the activation spreads and the associated setof electrode parameters as the training data.

The ANNs were used to design a predictor function of the form P=wI+b,which linearized the complex non-linear relationships betweenstimulation settings (I) and the equation parameters (P) describing the3D tissue activation, where w and b represent the weights and biases,respectively. The ANN finds the set of weights and biases mapping theseinputs to their corresponding outputs. The first ANN was used tocalculate the vertical and lateral spread of activation for each activeregion. The second ANN was used to calculate the vertical center of eachactive region. Because the model was axi-symmetric, the 2D boundaries ofactivation could be swept along the major axis of the virtual electrodeto generate 3D volumes of tissue activated. Use of the ANNs allowedinterpolation between stimulation settings that were not explicitlyanalyzed through the FEM solutions and NEURON simulations. This allowedselection of any stimulation setting within the parameter space togenerate a 3D VTA within the brain.

Each artificial neural network was created using MATLAB's neural networktoolbox (Mathworks Inc., Natick, Mass.), Each network received 12inputs: stimulation parameter set, pulse-width, encapsulationconductivity, contact configuration, voltage amplitude, and Booleanflags (1=active, 0=inactive) describing the electrode configuration(i.e., active contacts). Each ANN also included one hidden layer with 20neurons using a sigmoid transfer function and a linear output layer. Thefirst neural network had eight outputs (radial and vertical spread ofsimulation for each active region) and the second neural network hadfour outputs (ellipsoid center along the electrode shaft for each activeregion).

Both neural networks were trained using the Levenberg-Marquardtalgorithm on a random sampling of 70% of the stimulation settings andtheir corresponding ellipsoid parameters. The remaining 30% of the datawere used for validation and assessing the performance of the neuralnetworks. The initial weights of each ANN were initialized randomly, andthe stopping criteria used to terminate training included a mean squarederror less than 10⁻⁵ or up to 500 epochs.

With the predictor function, it is possible to calculate the ellipseequation parameters that defined the volume of tissue activation for awide range of multipolar electrode configurations and stimulationsettings. The input (I) consisted of 12 valuesI=[PW,σ _(encap) ,n,V,c ₀ ,c ₁ ,c ₂ ,c ₃ ,e ₀ ,e ₁ ,e ₂ ,e ₃],where PW is the pulse-width, σ_(encap) is the conductivity of the tissueencapsulation layer surrounding the electrode (dynamically based onpatient-specific impedance values), n is the configuration number forthe specific stimulation settings, V is the voltage amplitude, C₀₋₃ arethe explicit contact configurations (0 if dormant, −1 if cathode, and +1if anode), and

₀₋₃ are the active ellipsoids generated based upon the active contactconfigurations using a pseudo-algorithm as follows: *Set

₀₋₃ to 1 if the corresponding C₀₋₃ contacts are active; *If there are noanodes in contacts C₀₋₃, then determine if there are adjacent cathodes;*If there are adjacent cathodes, then set 1 to the active

₀₋₃ corresponding to the lowest adjacent cathode contact(s) and 0 to theactive

₀₋₃ corresponding to the higher adjacent cathode contact(s). Thispseudo-algorithm demonstrates an example of how adjacent active regionscan be combined if any overlap is present.

The ellipse parameters were solved using weights and biases calculatedfor each electrode type by the artificial neural networks. The inputs ofthe ANN were normalized to the range ±1 prior to calculation of theoutputs. The normalized inputs (I_(norm)) were defined by:

${I_{norm} = \frac{{2 \times I} - I_{\max} - I_{\min}}{I_{\max} - I_{\min}}},$where I_(max) and I_(min), are matrices containing the extreme maximumand minimum values of each input parameter, respectively.

The calculation of the normalized output (O_(norm)) was performed usingthe generalized sigmoid-based equation:

${O_{norm} = {\frac{W_{layer}}{1 + e^{- {({{W_{input} \times I_{norm}} + b_{input}})}}} + b_{layer}}},$where W_(layer) and W_(input) are the layer and input weights,respectively, and b_(layer) and b_(input) are the layer and inputbiases, respectively. The final output (O) was defined as:

${O = \frac{{O_{norm} \times ( {T_{\max} - T_{\min}} )} + T_{\max} + T_{\min}}{2}},$where T_(max) and T_(min) are matrices containing the extreme maximumand minimum values of each output parameter, respectively. The outputwas an 8×1 (network 1) or 4×1 (network 2) matrix containing theparameters for the parametric equation. For example, in the case of theequation for an ellipsoid of the form x²/a²+y²/b²+z²/c²=1, the a and cparameters for each active ellipse, and the z center of each activeellipse, respectively. The VTAs were, visualized in 3D along with theirappropriate virtual electrode using the SCIRun/BioPSE visualizationenvironment.

In certain embodiments, the present invention provides acomputer-implemented method for determining the volume of activation ofneural tissue. The method uses one or more parametric equations thatdefine a volume of activation. The parameters of the parametricequations are given as a function of an input vector. As explainedabove, the input vector may include stimulation parameters and/orelectrode configuration parameters. Also as explained above, examples ofsuch stimulation parameters include voltage or current amplitude,frequency, pulse width, and pulse shape. Also as explained above, theelectrode configuration parameters can define structural characteristicsof the electrode, such as its dimensions (e.g., height and diameter ofthe electrode contacts) or the spacing or distribution of the electrodecontacts. Also as explained above, the parametric equations mayrepresent various geometric shapes, such as ellipsoid shapes (includingsuper-ellipsoid shapes). In some cases, the function defining theparameters of the parametric equation may be a linear function of theinput vector. In other cases, the function defining the parameters ofthe parametric equation may be a non-linear function of the inputvector.

The desired stimulation parameters and/or electrode configurationparameters are received as input data. The values in the input data areused to define the input vector for the function. For example, the inputdata may include values for pulse width, encapsulation tissueconductivity, voltage, and electrode contact configuration, and thesevalues are used to define the corresponding variables in the inputvector. The output of the function can then be calculated, which is thenused to define the parameters of the parametric equation. For example,in the case of a parametric equation for an ellipse(x²/a²+y²/b²+z²/c²=1), the output of the function can define theparameters of the ellipse. This parametric equation can then be solvedfor the volume of activation as an ellipsoid shape. Thus, this methodallows for the volume of activation to be calculated directly from thesolution to the parametric equation.

As explained above, the parametric equation used to calculate the volumeof activation can be obtained using a computational training algorithm,such as an artificial neural network. In particular, the computationaltraining, algorithm can be used to design a function that correlatesdifferent stimulation parameters and/or electrode configurationparameters to the volumes of activations (i.e., the training data set)produced by the different stimulation parameters and/or electrodeconfiguration parameters.

This training data set can be obtained by coupling an electric fieldmodel to a neural tissue model to obtain volumes of activation formultiple different sets of stimulation parameters and/or configurations.Examples of how an electric field model can be coupled to a neuraltissue model to calculate a volume of activation are described in U.S.Pat. No. 7,346,382 (McIntyre et al.), U.S. Patent ApplicationPublication No. 2007/0288064 (Butson et al.), and U.S. PatentApplication Publication No. 2009/0287271 (Blum et al.), which are allincorporated by reference herein.

As explained above, in some cases, these volumes of activation can befit to a geometric shape defined by a parametric equation. Also asexplained above, this fitting of the volume of activation can beperformed using an optimization algorithm. Thus, with this information,the training set may include multiple different sets of electrodeparameters (stimulation settings and configurations) and the parametersfor the parametric equation (s) that represent the geometric shapes thathas been fitted to the volumes of activation associated with set ofelectrode parameters.

As explained above, in some cases, the computational training algorithmuses an artificial neural network. The artificial neural network may beused to infer the mapping between the electrode parameters and theparameters of the parametric equation for the geometric shape that hasbeen fitted to the volume of activation that is associated with set ofelectrode parameters. Using this training data set as the input, theoutput of the artificial neural network can be used to design a functionthat maps this relationship. An example of an artificial neural networkthat can be used in the present invention is shown in FIG. 10. Thisartificial neural network has three layers: an input layer (the nodes onthe left), an output layer (the nodes on, the right), and anintermediate, hidden neuron layer (the nodes in the middle). The insetshows how the weights (W_(n,h)) and biases are used to change theparameters of the throughput and vary the neural connections in theneural network.

In certain embodiments, the present invention provides a method fordetermining a function that outputs the parameters of one or moreparametric equations that define a volume of activation. The methodcomprises having an electric field model of an electrode and a neuraltissue model. By coupling; the electric field model to the neural tissuemodel as explained above, volumes of activation can be obtained formultiple different sets of stimulation parameters and electrodeconfiguration parameters. A geometric shape (e.g., an ellipsoid), whichis defined by one or more parametric equations, is fitted to the volumesof activation. As explained above, this may be performed using anoptimization algorithm.

Also as explained above, a computational training algorithm may be usedto design a function that correlates the different sets of stimulationparameters and electrode configuration parameters to the parameters forthe one or more parametric equations that represent the geometric shapesthat are fitted to the volumes of activation. Flaying designed such afunction, this function may be incorporated into computer software(embodied as non-transitory computer-readable storage medium) thatcomprises instructions for determining the volume of activation usingone or more parametric equations whose parameters are given as thefunction of an input vector that includes stimulation parameters and/orelectrode configuration parameters.

Computing Environment

Certain embodiments of the invention have also been described hereinwith reference to block illustrations of methods, systems, and computerprogram products. It will be understood that blocks of theillustrations, and combinations of blocks in the illustrations, can beimplemented by computer-executable instructions. Thesecomputer-executable instructions may be provided to one or moreprocessor of a general purpose computer, special purpose computer, orother programmable data processing apparatus (or a combination ofdevices and circuits) to produce a machine, such that the instructions,which execute via the processor, implement the functions specified inthe block or blocks.

These computer-executable instructions may also be stored incomputer-readable memory that can direct a computer or otherprogrammable data processing apparatus to function in a particularmanner, such that the instructions stored in the computer-readablememory result in an article of manufacture including instructions whichimplement the function specified in the flowchart block or blocks. Thecomputer program instructions may also be loaded onto a computer orother programmable data processing apparatus to cause a series ofoperational steps to be performed on the computer or other programmableapparatus to produce a computer-implemented process such that theinstructions which execute on the computer or other processor-basedapparatus provide steps for implementing the functions specified in theblock or blocks.

In this regard, FIG. 7 illustrates one example of a computer system 500that can be employed to execute one or more embodiments of the inventionby storing and/or executing computer executable instructions. Computersystem 500 can be implemented on one or more general purpose networkedcomputer systems, embedded computer systems, routers, switches, serverdevices, client devices, various intermediate devices/nodes or standalone computer systems. Additionally, computer system 500 can beimplemented on various mobile clients such as, for example, a personaldigital assistant (PDA), laptop computer, pager, and the like, providedit includes sufficient processing capabilities.

Computer system 500 includes processing unit 501, system memory 502, andsystem bus 503 that couples various system components, including thesystem memory, to processing unit 501. Dual microprocessors and othermulti-processor architectures also can be used as processing unit 501.System bus 503 may be any of several types of bus structure including amemory bus or memory controller, a peripheral bus, and a local bus usingany of a variety of bus architectures. System memory 502 includes readonly memory (ROM) 504 and random access memory (RAM) 505. A basicinput/output system (BIOS) 506 can reside in ROM 504 containing thebasic routines that help to transfer information among elements withincomputer system 500.

Computer system 500 can include a hard disk drive 507, magnetic diskdrive 508, e.g., to read from or write to removable disk 509, and anoptical disk drive 510, e.g., for reading CD-ROM disk 511 or to readfrom or write to other optical media. Hard disk drive 507, magnetic diskdrive 508, and optical disk drive 510 are connected to system bus 503 bya hard disk drive interface 512, a magnetic disk drive interface 513,and an optical drive interface 514, respectively. The drives and theirassociated computer-readable media provide nonvolatile storage of data,data structures, and computer-executable instructions for computersystem 500. Although the description of computer-readable media aboverefers to a hard disk, a removable magnetic disk and a CD, other typesof non-transitory computer-readable media that are readable by acomputer, such as magnetic cassettes, flash memory cards, digital videodisks and the like, in a variety of forms, may also be used in theoperating environment; further, any such media may containcomputer-executable instructions for implementing one or more pans ofthe invention. The term “non-transitory computer-readable storagemedium” encompasses all computer-readable storage media, with the soleexception being a transitory, propagating signal.

A number of program modules may be stored in drives and RAM 505,including operating system 515, one or more application programs 516,other program modules 517, and program data 518. The applicationprograms and program data can include functions and methods programmedto train a neural network, provide a neural network or otherwise enablea user to interact with or interface with the network via a userinterface, such as shown and described herein.

A user may enter commands and information into, computer system 500through one or more input devices 520, such as a pointing device (e.g.,a mouse, touch screen), keyboard, microphone, joystick, game pad,scanner, and the like. For instance, the user can employ input device520 to edit or modify a domain model. Additionally or alternatively, auser can access a user interface via the input device to create one ormore instances of a given domain model and associated data managementtools, as described herein. These and other input devices 520 are oftenconnected to processing unit 501 through a corresponding port interface522 that is coupled to the system bus, but may be connected by otherinterfaces, such as a parallel port, serial port, or universal serialbus (USB). One or more output devices 524 (e.g., display, a monitor,printer, projector, or other type of displaying device) is alsoconnected to system bus 503 via interface 526, such as a video adapter.

Computer system 500 may operate in a networked environment using logicalconnections to one or more remote computers, such as remote computer528. Remote computer 528 may be a workstation, computer system, router,peer device, or other common network node, and typically includes manyor all the elements described relative to computer system 500. Thelogical connections, schematically indicated at 530, can include a localarea network (LAN) and a wide area network (WAN).

When used in a LAN networking environment, computer system 500 can beconnected to the local network through a network interface or adapter532. When used in a WAN networking environment, computer system 500 aninclude a modem, or can be connected to a communications server on theLAN. The modem, which may be internal or external, can be connected tosystem bus 503 via an appropriate port interface. In a networkedenvironment, application programs 516 or program data 518 depictedrelative to computer system 500, or portions thereof, may be stored in aremote memory storage device 540.

What have been described above are examples and embodiments of theinvention. It is, of course, not possible to describe every conceivablecombination of components or methodologies for purposes of describingthe invention, but one of ordinary skill in the art will recognize thatmany further combinations and permutations of the present invention arepossible. Accordingly, the invention is intended to embrace all suchalterations, modifications and variations that fall within the scope ofthe appended claims. In the claims, unless otherwise indicated, thearticle “a” is to refer to “one or more than one.”

What is claimed is:
 1. A system for determining parameters forelectrical stimulation, the system comprising: a volume of tissueactivated (VTA) estimator configured to estimate, for each set ofstimulation parameter values input into the VTA estimator, a volume oftissue that is activated by electrical stimulation using the set ofstimulation parameter values, wherein the VTA estimator comprises anartificial intelligence module to estimate the volume of tissue isactivated by electrical stimulation using the set of stimulationparameter values and a training module to train the artificialintelligence module; a user interface coupled to the VTA estimator andconfigured for selection of a target volume, for input of training datato the training module, and for input of at least one of the sets ofstimulation parameter values; and a display coupled to the VTA estimatorand the user interface and configured for displaying the target volumeand the estimates generated by the VTA estimator.
 2. The system of claim1, wherein the artificial intelligence module comprises an artificialneural network.
 3. The system of claim 1, wherein the VTA estimatorfurther comprises a VTA model module.
 4. The system of claim 3, whereinthe VTA model module comprising at least one parametric equation modelthat defines a volume of activation.
 5. The system of claim 4, whereinat least one of the at least one parametric equation module comprisesone or more parametric equations that represent a geometric shape. 6.The system of claim 5, wherein the geometric shape is an ellipsoid shapeor a super ellipsoid shape.
 7. The system of claim 3, wherein the VTAmodel module comprises having an electric field model of an electrode.8. The system of claim 3, wherein the VTA model module comprises aneural tissue model.
 9. The system of claim 1, wherein the set ofstimulation parameter values comprises a value for each of one or moreof pulse width, electrode contact impedance, encapsulation tissueconductivity, voltage, or electrode contact configuration.
 10. Thesystem of claim 1, further comprising a correlator configured forcorrelating the target volume with the estimates generated by the VTAestimator.
 11. The system of claim 10, wherein the correlator isconfigured to provide a score indicative of an amount of overlap betweenthe target volume and a one of the estimates generated by the VTAestimator.
 12. A method of determining electrical stimulation parametersfor providing electrical stimulation to a patient, the methodcomprising: receiving a target volume; estimating, for each set ofstimulation parameter values, a volume of tissue that is activated byelectrical stimulation using the set of stimulation parameter valuesusing a VTA estimator, wherein the VTA estimator comprises an artificialintelligence module to estimate the volume of tissue is activated byelectrical stimulation using the set of stimulation parameter values anda training module to train the artificial intelligence module; comparingthe estimated volumes of tissue with the target volume; and selecting,based on the comparisons, one of the estimated volumes of tissue and thecorresponding set of stimulation parameter values.
 13. The method ofclaim 12, wherein the artificial intelligence module comprises anartificial neural network.
 14. The method of claim 12, wherein the VTAestimator further comprises a VTA model module.
 15. The method of claim14, wherein the VTA model module comprising at least one parametricequation model that defines a volume of activation.
 16. The method ofclaim 15, wherein at least one of the at least one parametric equationmodule comprises one or more parametric equations that represent ageometric shape.
 17. The method of claim 16, wherein the geometric shapeis an ellipsoid shape or a super ellipsoid shape.
 18. The method ofclaim 14, wherein the VTA model module comprises having an electricfield model of an electrode.
 19. The method of claim 14, wherein the VTAmodel module comprises a neural tissue model.
 20. The method of claim12, wherein the set of stimulation parameters values comprises a valuefor each of one or more of pulse width, electrode contact impedance,encapsulation tissue conductivity, voltage, or electrode contactconfiguration.